As the weather heats up, public swimming pools beckon us to leave the comfort of our homes and venture outdoors to take a cool dip. Swimming in the public pool may be considered one of America’s favorite pastimes, but for me, no thanks. My 5 Top Reasons You Should Never Get Into A Public Swimming Pool will give you the extra ammunition you need when kids ask, “Can we go to the public pool?”

Poop

"The average bather has about a tenth of a gram of feces in his gluteal fold, which is a nice way of saying butt crack," says Charles Gerba, a professor of microbiology and environmental studies at The University of Arizona. That means with five people, "you have a tablespoon of poop in the pool." Moreover, beyond the gross-out factor, without safe levels of disinfectant, you can run the risk of transmitting diseases, he says.

A CDC report of routine pool inspections released in 2010 found that nearly one in eight pools posed serious violations that threatened public health, which resulted in those pools being closed immediately.

Pee

One in 5 adults admit to peeing in a pool. Even Olympic swimmer Michael Phelps confessed, “I think everybody pees in the pool,” Phelps told The Telegraph in 2012. “It’s kind of a normal thing to do for swimmers. When we’re in the water for two hours, we don’t really get out to pee. Chlorine kills it, so it’s not bad.”

When urine (and other waste, such as sweat) mixes with chlorine, it creates an irritant called chloramine, which is what causes red, stinging eyes when swimming and can also irritate your respiratory tract, Michele Hlavsa, an epidemiologist and chief of healthy swimming for the Centers for Disease Control of Prevention explains. "It's really important to not use the pool as a restroom," she says. Chloramines are also what causes that "chlorine smell," which is a red flag for contamination.

Cryptosporidium ("Crypto")

Cryptosporidium — or Crypto, for short — is a parasite that causes the diarrheal disease cryptosporidiosis. In a new report, the CDC noted 1,788 water-associated illnesses were reported between 2011 and 2012, including 95 cases that required hospitalization and one death in 32 states and Puerto Rico. Of those, the agency said Cryptosporidium was responsible for more than half the cases stemming from treated water in pools and hot tubs. While most bacteria can live in treated water for only a few hours at most, Cryptosporidium can hang on for up to 10 days. It’s protected by an outer shell that allows the parasite to survive for up to 10 days even in chlorine-treated water, so even well-maintained pools can spread Crypto among swimmers. To be safe, the CDC advises checking to see when the pool you're using was most recently inspected. Be sure you or your children don't swallow water while swimming. Also, to make sure you're not contributing to the problem, the CDC advises against swimming when you have diarrhea and for two weeks afterward, especially if you know that Cryptosporidium was the cause. Take young children to the bathroom frequently (and talk to them about not peeing or pooping in the water).

Bacteria - E. Coli

The CDC released a new study about what's lurking in the pool water. Water sampled from 161 pools in the Atlanta area showed signs of E. Coli — the bacteria most commonly associated with fecal matter.

When you forgo rinsing with soap and water before entering the pool, you introduce fecal matter into the water. A simple shower with soap before entering the water can significantly cut the risk of contamination. Check out this article on Why you SHOULD shower before you use the pool.

Be sure to change diapers in the bathroom or designated diaper-changing area — not poolside, which increases the risk of germs getting into the water.

RWI

Recreational water illnesses (RWIs) are caused by germs that are spread by swallowing contaminated water present in swimming pools, hot tubs, water parks, lakes, and oceans. According to the CDC, there has been an increase in the number of RWI outbreaks in the past two decades.

The most common RWI is diarrhea (caused by Crypto or E-coli). Other RWI infections include:

Gastrointestinal Skin Ear Respiratory Eye Neurologic Wound

Chlorine and other disinfectants don't kill germs instantly. Also, the mixing of chlorine with pee and sweat uses up the chlorine in the pool that would otherwise kill germs. That's why keeping chlorine at recommended levels is essential to maintain a healthy pool. If you notice a strong odor of chlorine at a public pool, it's not a good thing. It indicates a maintenance problem. A well-chlorinated pool should, in fact, have little odor.

Summer is not much fun if the water you swim in makes you sick. So be advised, if you decide to take a dip in the pool – you’ve been warned!

Emily Woll writes for North American Healthcare Inc. and drosmond.com.

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More than one-third (34.9 percent) of American adults are obese, according to the 2011-2012 National Health and Nutrition Examination Survey. A person is clinically obese if their body mass index (BMI) level is 30 or more. Overweight and obesity have become pressing global health concerns. With a higher number of bariatric and aging patients comes an increased demand for skilled nursing and rehabilitation facilities that can accommodate their unique care needs. Historically, bariatric patients have faced challenges when trying to find long-term care. Skilled nursing facilities (SNFs) and assisted living facilities (ALFs) are having to innovate to accommodate these patients and provide high-quality care.

There are facilities that can accommodate obese patients and provide excellent care, but they may require a bit more effort and research to find. There are a few things to keep in mind when trying to locate a skilled nursing, rehab or assisted living care for a bariatric patient.

Specialized Equipment for Bariatric Patients

Ask if the facility has bariatric equipment. The Occupational Safety and Health Administration (OSHA) limits how much healthcare workers are allowed to lift, so if the patient needs help getting in and out of bed toileting or bathing, special equipment will be necessary. This can include larger beds (a standard hospital bed can only hold up to 350 pounds), chairs, wheelchairs and mobility aids, and shower and bath equipment, depending on you or your love one’s needs. A heavier individual may require an electric patient lift instead of manual equipment such as a classic Hoyer lift.

Because these items are extremely expensive, the number of beds available to accommodate heavier residents at any given location will be extremely limited. Waiting lists are typically quite long, since nursing facilities are not obligated to accept patients like hospitals are.

Proper Training

Patient transfers can be tricky and dangerous for individuals of an average weight, so great care must be taken when caregivers assist heavier residents. This is for the patient’s safety and that of the facility’s employees.

“The largest risk is the issue of injuring patients and caregivers from improper transfer,” says Jeff Oldroyd from Holladay Healthcare, a nursing home located in Salt Lake City, Utah. “We do give additional training in these specific transfers to our caregivers. This training is usually provided by experienced nurses and physical therapists.”

Do not be afraid to ask the facility about special training and experience requirements for any staffers who may be caring for you or your loved one. Frequent transfers and repositioning are crucial for proper hygiene and prevention of bedsores or compression ulcers.

Adequate Space in Living Areas

A larger room or apartment is ideal for larger patients in care facilities, but do not forget to inspect communal areas such as dining rooms and activity rooms as well. Isolation can be a real concern for these patients since their mobility is typically limited. Make sure there is enough space to maneuver a larger wheelchair in the facility so you or your loved one can interact with staff and other guests outside of their room. Creating opportunities for a patient to engage and participate in social and recreational activities will improve their quality of life and may even result in weight management or even weight loss.

Appropriate Activities

While resident involvement is important, bariatric patients have specific health and activity needs. In many cases, “regular” exercise is not possible or safe for them. Make sure to ask the facility about modified activities for patients, especially if they have recently undergone surgery. This is especially important in a rehabilitation setting where a patient is working to heal and regain or improve their functional abilities. For instance, a facility with a pool and a water therapy program can provide activity options that are more conducive than typical weight-bearing and high-impact exercise programs. An experienced physical therapist will be able to adapt a PT regimen to make sure they meet their health care goals.

Compassionate Staff

Overweight patients are likely accustomed to comments about weight and physical activity. But, beyond the equipment and therapy, it’s important to know that the staff will see a bariatric patient as more than just a number on the scale. It can be difficult for anyone to find placement in a facility, and you want to make sure any special needs will be taken care of.

Ask Your Physician

Physicians often have contacts at many skilled nursing, assisted living, and rehabilitation facilities in their area. In many cases, they may be your best resource when it comes to finding a reputable facility. Communication between the facility and a physician will be key for ongoing care, so receiving a referral from your doctor will be an added bonus.

“We do have additional communication with physicians for patients with specialized needs such as obesity,” said Mark Hymas from Copper Ridge Health Care, a SNF in West Jordan, Utah. “There are specific protocols for each diagnosis, and those symptoms are monitored and shared with physicians in real time. Physicians are then able to make determinations to monitor and adjust treatments.”

Patients of any size may encounter significant obstacles and frustrations related to their healthcare. Finding a facility with the proper equipment and training, adequate space, appropriate exercise and activity programs, and compassionate staff can be difficult. However, these important tips will help you select the right care setting for yourself or your loved one.

This article was originally published by AgingCare.com. It has been republished here with permission.

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